Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $812.83 / $6,025.60	Facility		$218.78	$812.83	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $776.25	Professional		$199.53	$281.84	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $707.95	Professional		$323.59	$549.54	$707.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $316.23 / $676.08	Professional		$199.53	$316.23	$676.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $524.81 / $5,248.07	Facility		$263.03	$524.81	$5,248.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $489.78 / $1,584.89	Professional		$239.88	$489.78	$1,584.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $524.81 / $630.96	Professional		$467.74	$524.81	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $630.96	Professional		$407.38	$467.74	$630.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $489.78	Professional		$199.53	$363.08	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $5,248.07 / $7,413.10	Facility		$2,951.21	$5,248.07	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $323.59 / $616.60	Professional		$213.80	$323.59	$616.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $537.03	Professional		$363.08	$457.09	$537.03